利用肿瘤护士导航增加少数族裔患者参与癌症临床试验。

Increasing minority patient participation in cancer clinical trials using oncology nurse navigation.

机构信息

University of Southern California Kenneth Norris Jr. Comprehensive Cancer Center, Los Angeles, CA 90033, USA.

出版信息

Am J Surg. 2012 Apr;203(4):415-22. doi: 10.1016/j.amjsurg.2011.02.005. Epub 2011 Oct 13.

DOI:10.1016/j.amjsurg.2011.02.005

PMID:21996347

Abstract

BACKGROUND

Residential distance from an academic or cancer center is a significant barrier to minority patient participation in cancer research. Most cancer clinical trials (CTs) are only accessible at academic and cancer centers, yet most cancer patients receive treatment in their home communities where access to CTs may be limited. Oncology nurse navigation is an innovative approach for increasing minority CT participation by facilitating access to cancer CTs in communities where minority patients live. The purpose of this study was to evaluate the impact of oncology nurse navigation on community-based recruitment of black patients to breast cancer CTs at a major cancer center.

METHODS

We merged the roles of a traditional oncology research nurse and a professional patient navigator to create a novel health care provider role, the oncology nurse navigator. The primary duties of the oncology nurse navigator were to engage black cancer patients in the offices of their community physicians and to collaborate with community physicians to increase black patient participation in cancer research. The oncology nurse navigator played a key role in all phases of the CT participation process (e.g., screening for eligibility and completion of informed consent and clinical research forms) and guided each patient around barriers in the health care system. The accrual of eligible patients to breast cancer CTs was used to assess the impact of oncology nurse navigation on community-based recruitment of blacks to cancer CTs.

RESULTS

Between January 2007 and December 2008, a total of 132 black breast cancer patients were screened by a single oncology nurse navigator for eligibility to University of Southern California-sponsored breast cancer CTs. Fifty-nine patients were eligible for CTs, and each was invited to participate in 1 or more CTs for which they were eligible. Fifty-one of 59 eligible black patients (86% of eligible patients) were enrolled to 1 or more research protocols. The estimated cost per enrolled patient was $5,677, nearly half the expected per patient cost of treating patients on CT at an academic or cancer center.

CONCLUSIONS

Oncology nurse navigation is an effective outreach strategy for increasing black patient participation in cancer research and may be achieved at nearly half the cost of traditional methods of enrolling patients in CTs at cancer centers.

摘要

背景

居住地点与学术或癌症中心的距离是少数族裔患者参与癌症研究的一个重要障碍。大多数癌症临床试验（CTs）仅在学术和癌症中心进行，但大多数癌症患者在其所在社区接受治疗，而在这些社区，获得 CT 的机会可能有限。肿瘤护士导航是一种通过在少数族裔患者居住的社区为他们提供获取癌症 CT 的途径来增加少数族裔 CT 参与度的创新方法。本研究旨在评估肿瘤护士导航对在一家主要癌症中心招募黑人参与乳腺癌 CT 的基于社区的招募的影响。

方法

我们将传统的肿瘤学研究护士和专业的患者导航员的角色合并，创建了一种新的医疗保健提供者角色，即肿瘤护士导航员。肿瘤护士导航员的主要职责是让黑人癌症患者参与他们社区医生的办公室，并与社区医生合作，增加黑人患者参与癌症研究的机会。肿瘤护士导航员在 CT 参与过程的所有阶段都发挥了关键作用（例如，筛选合格人员以及完成知情同意书和临床研究表格），并引导每位患者克服医疗保健系统中的障碍。合格患者入组乳腺癌 CT 用于评估肿瘤护士导航对基于社区的黑人癌症 CT 招募的影响。

结果

在 2007 年 1 月至 2008 年 12 月期间，一名肿瘤护士导航员共对 132 名黑人乳腺癌患者进行了筛查，以确定他们是否有资格参加南加州大学赞助的乳腺癌 CT。59 名患者有资格参加 CT，并且每位患者都被邀请参加一项或多项他们有资格参加的 CT。59 名合格黑人患者中的 51 名（合格患者的 86%）入组了一项或多项研究方案。每位入组患者的估计成本为 5677 美元，几乎是在癌症中心治疗 CT 患者的每位患者预期成本的一半。